三维数字减影血管造影对脑动脉瘤的诊断价值

目的：探讨三维数字减影血管造影（3DDSA）对脑动脉瘤的诊断价值。方珐：对91例确诊或疑诊脑动脉瘤患者的2DDSA和3DDSA检查结果进行回顾性对比分析，以呐动脉瘤手术和血管内治疗为参照。结果：91例患者3DDSA共检出64例92个动脉瘤，27例阴性，2DDSA共检出61例79个动脉瘤，30例阴性，2DDSA和3DDSA脑动脉瘤诊断阳性率比较差异无统计学意义（P〉0．05）。2DDSA有1例假阳性和4例假阴性，有10例13个动脉瘤朱被2DDSA发现（平均1．98ram），偶然发现未破裂动脉瘤占84．6％。3DDSA对于动脉瘤瘤颈的显示及瘤颈和周围重要血管毗邻关系的评价优于2DDSA（P〈0．01）。结论：3DDSA对于脑动脉瘤的诊断和治疗具有很大的临床应用价值。

The value of 2DDSA and 3DDSA in diagnosis of intracranial aneurysms

Objective:To evaluate the value of 3DDSA in the diagnosis of intracranial aneurysms. Methods: Two-dimensional digital subtraction angiography (2DDSA) and three-dimensional digital subtraction angiography (3DDSA) were performed and analysed in 91 patients with confirmed or suspected aneurysms. Results:Compared with the surgry and endovascular treatment, ninety-two aneurysms were found in 64 patients and nothing were found in 27 with 3DDSA. Seventy-nine aneurysms were found in 61 patients and nothing was found in 30 with 2DDSA. There was no statistically significant difference in ansurysm detection rate between 3DDSA and 2DDSA (P >0. 05). But there were one false-positive and four false-negative detection of aneurysms in 2DDSA. 2DDSA failed to dectect thirteen aneurysms (average dimatar: 1. 98 mm, incidental unruptured aneurysms: 84. 6%). For visualization of aneurysms neck and relationship to neighboring arteries, 3DDSA images were significantly superior to those of 2DDSA (P <0. 01). Conclusions: More accurate diagnosis and secure treatment of intracranial aneurysm can be reached by 3DDSA. It is siginficantly valuable in clinical practise.